The use of anticancer chemotherapy (ACC) has resulted in longer patient survival but has also increased drug-related adverse effects. A 22-year-old female receiving cisplatin-based intravenous chemotherapy for high risk variant of gestational trophoblastic neoplasia (GTN) presented with complaints of sudden painless loss of vision in her right eye for a duration of 4 hours. Ocular findings were suggestive of central retinal artery occlusion (CRAO). After exclusion of other potential aetiological risk factors, the patient was diagnosed with CRAO associated with cisplatin. Cancer patients are prone to thromboembolic events (TEE) not only due to primary disease but also due to underlying comorbidities and treatment modalities. The high incidence of TEE in patients under cisplatin therapy mandates a high degree of suspicion among the treating physicians. This rare possibility of irreversible visual toxicity should also be considered among the patients under cisplatin chemotherapy.To report a case of a full-thickness macular hole (MH) that developed after cryotherapy and intravitreal bevacizumab injection (IVB) to treat a retinal vasoproliferative tumor (VPT).
Case report of a man with a retinal VPT.
A 64-year-old Japanese man complained of blurred vision in his right eye. At the initial examination, his best-corrected visual acuity (BCVA) was 20/25 in the right eye and 20/20 in the left eye. Ophthalmoscopy showed a VPT in the lower peripheral retina of the right eye. An exudative retinal detachment and hard exudates were seen around the tumor. Cryotherapy and intravitreal injections of bevacizumab (IVB) were performed. Although the exudative changes were reduced, a MH developed two months after the initial IVB treatment. He underwent 25-gauge pars plana vitrectomy, and the MH was closed. His postoperative BCVA was 20/32 and the VPT was inactive. The reduced BCVA was due to damage of the outer retinal layers.
Our findings indicate that cryotherapy and IVB are effective treatments for VPT although the possibility of developing a MH should be considered.
Our findings indicate that cryotherapy and IVB are effective treatments for VPT although the possibility of developing a MH should be considered.A 36 year old male presented with a two-month history of a progressively increasing proptosis of the right eye associated with redness. MRI of brain and orbit revealed a mass in the intraconal compartment in the lateral aspect of the right orbit that had T1, T2, and FLAIR high signal intensity and was completely suppressed in the STIR image. Excisional biopsy of the mass resolved the proptosis, and histology revealed encapsulated tumor composed of lobules of mature adipocytes along with fibro collagenous septa. Thus, diagnosis of lipoma was established that has uncommon occurrence in the orbital region.We present a series of four patients who had been admitted to two hospitals in Addis Ababa after presenting with persistent and chronic diarrhoea. All patients were subsequently diagnosed to have Clostridioides difficile-associated pseudomembranous colitis, a disease that has long been regarded as a rare diagnosis in sub-Saharan Africa, and which has not yet been reported in Ethiopia. This case series is believed to create a much-needed awareness among physicians on the existence of this treatable but potentially fatal disease.Vernal keratoconjunctivitis (VKC), an allergic disease, has a known association with ectatic disorders of the cornea. Pellucid marginal degeneration (PMD) is a bilateral, asymmetrical, ectatic disorder of the cornea characterized by inferior corneal thinning. We report a case of sensory exotropia due to PMD in association with VKC.
A 19-year old boy with a history of VKC presented with exotropia of the right eye of 3 years' duration. His unaided vision in his right eye was 1/60 and in his left eye it was 6/36. On examination, both eyes had high against the rule astigmatism, which was more in the right eye. There was exotropia of 15º (40 prism diopter base in) in the right eye with suppression (Worth four dot test). Corneal examination in both eyes showed inferior band thinning, 2 mm above the inferior limbus, extending from 4 to 8 clock hours, with bulging of the cornea just above the thinning. The clinical features were suggestive of PMD, which was supported by his corneal scans - Atlas, Pentacam, and Optovue. Although he was undergoing treatment for VKC, the onset of PMD and decrease in vision went unnoticed. The asymmetric error which was not corrected during the sensitive period of visual development led to sensory exotropia.
A child with VKC should undergo regular refraction so as not to miss any ectatic changes occurring in the cornea. A delay in diagnosing corneal ectasia may negate the possibility of collagen cross-linking which prevents progression of ectasia. If visual rehabilitation is delayed beyond the age of visual maturation, it can lead to strabismus, suppression, and loss of binocular function.
A child with VKC should undergo regular refraction so as not to miss any ectatic changes occurring in the cornea. A delay in diagnosing corneal ectasia may negate the possibility of collagen cross-linking which prevents progression of ectasia. If visual rehabilitation is delayed beyond the age of visual maturation, it can lead to strabismus, suppression, and loss of binocular function.Although the most common uterine tumour is leiomyoma, the differential diagnoses also include the rarer adenomyoma and leiomyosarcoma. https://www.selleckchem.com/products/ly3039478.html A lack of clear reliable clinical and radiological features makes the triage of uterine masses to the appropriate surgical procedure difficult. In the case of suspicious appearance of a presumed leiomyoma, an open surgical approach is recommended and morcellation is avoided.
We present a case of a woman undergoing an elective laparoscopic myomectomy for a fibroid that appeared benign on ultrasound but had suspicious features intraoperatively. The operation was converted to a laparotomy to avoid the risk of morcellation-related seeding in the event that the histology was malignant. The histology was subsequently a benign exophytic adenomyoma.
The assessment of the nature of fibroids can be difficult both pre- and intraoperatively, and the need for difficult decision making to convert to open surgery during a laparoscopic myomectomy but with subsequent benign histology should be part of patient counselling.